Smoking did not modify the effects of anti-TNF treatment on health-related quality of life among Australian ankylosing spondylitis patients

Alison S R Kydd; Jian Sheng Chen; Joanna Makovey; Vibhasha Chand; Lyndall Henderson; Rachelle Buchbinder; Marissa Lassere; Lyn M March

doi:10.1093/rheumatology/keu314

Smoking did not modify the effects of anti-TNF treatment on health-related quality of life among Australian ankylosing spondylitis patients

Rheumatology (Oxford). 2015 Feb;54(2):310-7. doi: 10.1093/rheumatology/keu314. Epub 2014 Aug 29.

Authors

Alison S R Kydd¹, Jian Sheng Chen², Joanna Makovey¹, Vibhasha Chand¹, Lyndall Henderson¹, Rachelle Buchbinder³, Marissa Lassere¹, Lyn M March¹

Affiliations

¹ Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada, Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, CCRE Therapeutics, Monash University, Monash Department of Clinical Epidemiology, Cabrini Hospital, Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC and Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
² Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada, Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, CCRE Therapeutics, Monash University, Monash Department of Clinical Epidemiology, Cabrini Hospital, Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC and Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia. [email protected].
³ Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada, Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, CCRE Therapeutics, Monash University, Monash Department of Clinical Epidemiology, Cabrini Hospital, Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC and Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia. Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada, Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, CCRE Therapeutics, Monash University, Monash Department of Clinical Epidemiology, Cabrini Hospital, Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC and Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.

PMID: 25173348
DOI: 10.1093/rheumatology/keu314

Abstract

Objective: The aim of this study was to examine the impact of smoking on health-related quality of life (HRQoL) among AS patients who were taking biologic DMARDS.

Methods: This is a longitudinal cohort study of AS patients with anti-TNF treatment in the Australian Rheumatology Association Database (2003-11). They were assessed using the 36-item Short Form Health Survey (SF-36), Assessment of Quality of Life (AQoL) and HAQ for spondylitis (HAQ-S) on a biannual basis. Linear mixed models were used to assess the impact of smoking on HRQoL outcomes over the first 2 years of treatment.

Results: Four hundred and twenty-two patients [73% male, mean age 44.9 years (s.d. 12.7) provided 1189 assessments for the study. Current smokers (n = 79) were slightly younger, more likely to be male, less likely to use or to have previously used prednisolone and had a slightly shorter disease duration than past smokers (n = 138) or non-smokers (n = 205). After adjusting for smoking, gender, age, education, employment, co-morbidities and medication use, including DMARDs, anti-inflammatories and analgesics, all the HRQoL measures improved significantly over the study period and the improvements were not modified by smoking status (all P-values >0.36). Current smokers tended to have a poorer HRQoL on the SF-36 physical score [-1.93 (95% CI -3.94, 0.09), P = 0.06] and the HAQ-S score [0.10 (95% CI -0.01, 0.20), P = 0.07] compared with non-smokers.

Conclusion: Among AS patients, active smoking did not diminish or modify the improvements in HRQoL from anti-TNF treatment, even though current smokers compared with non-smokers tended to have poorer scores in some HRQoL measures.

Keywords: SF-36; ankylosing spondylitis; anti-TNF drugs; quality of life; smoking.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antirheumatic Agents / therapeutic use*
Biological Factors / therapeutic use*
Female
Humans
Longitudinal Studies
Male
Quality of Life
Smoking / adverse effects*
Spondylitis, Ankylosing / drug therapy*
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

Antirheumatic Agents
Biological Factors
Tumor Necrosis Factor-alpha